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Method and apparatus for surgical dissection

a technology of surgical dissection and tissue, applied in the field of tissue treatment, can solve the problems of three-dimensional dimpling of the skin, skin irregularities and deformities, and lumpy or bulging skin surface,

Inactive Publication Date: 2008-10-09
INMODE LTD
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Benefits of technology

[0019]Another object of the present invention is to provide an apparatus, and its methods of use, that delivers energy to a tissue site, dissect a tissue plane at a controlled depth, produces a tissue flap with a substantially uniform thickness while protecting or minimizing injury to tissue or structures within the flap
[0021]A further object of the present invention is to provide an apparatus, and its methods of use, that creates a uniform surgical release and mass shifting of overlying soft tissue structures from subjacent tissue structures by uniformly dissecting the overlying structures from the underlying tissue.
[0022]Yet another object of the present invention is to provide an apparatus, and its methods of use, that creates a uniform surgical release and a shifting of overlying soft tissue structures.
[0025]In another embodiment, an electro-surgical apparatus includes an electrode with a cutting edge. A housing is coupled to the electrode. The housing includes a top with a top proximal section and a bottom with a bottom proximal section. The top proximal section has a geometry that facilitates creation of a skin flap with a substantially uniform thickness that includes a skin layer and an adjacent layer of subcutaneous tissue. The bottom proximal section has a geometry that preserves a plane of tissue that is positioned adjacent to the adjacent layer of subcutaneous tissue
[0029]In another embodiment, a method of creating a tissue effect provides an electro-surgical device that includes an electrode with a cutting edge, a housing coupled to the electrode with a guide that provides for cutting a skin layer and an underlying thickness of subcutaneous tissue while preserving an adjacent plane of tissue. The cutting edge is positioned at the skin surface. The skin surface and a layer of an adjacent underlying tissue are cut. A tissue effect is created.

Problems solved by technology

There are many causes of skin irregularities and deformities including skin laxity, sun damage etc.
One of the more prominent causes of surface irregularities is cellulite which results in a dimpled, lumpy, or bulging skin surface.
This multifactorial complex of increasing tension of the fibrous septae, increasing size of fat loculations and progressive age related skin laxity results in a three dimensional dimpling of the skin.
This results in areas of the skin being held down while other sections bulge outward, resulting in the lumpy, ‘cottage-cheese’ appearance.
Flap necrosis is more likely to occur in cutaneous flaps because of their less robust vascular supply.

Method used

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  • Method and apparatus for surgical dissection
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  • Method and apparatus for surgical dissection

Examples

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Effect test

example 1

[0293]Referring now to FIGS. 64a-64f, an application of an embodiment of apparatus 10 can be the performance of a skin preservation mastectomy in which no breast skin is resected . . . only the nipple areolar complex is resected with the subjacent breast tissue. With a uniform flap dissecting embodiment of apparatus 10, a subcutaneous flap of the preserved breast skin is ‘closed dissected’ without direct visualization of the plane of dissection. Due to the superficial guide component of the electrode housing, a uniform flap thickness if created with the dissection of the breast skin envelope. The predetermined flap thickness will preserve the subdermal vascular plexus and thereby limit breast skin envelope necrosis. The correct flap thickness will also enhance the oncological effectiveness of the procedure by not leaving breast tissue on the breast skin flap. In other words, an uneven dissection with the side effects of a too thin or a too thick plane of dissection will be avoided. ...

example 2

[0294]Referring now to FIG. 65, for a facelift patient with redundant skin the cheeks, jowls and neck, a large continuous incision is made that starts in the temporal scalp, extends around the ear and ends in the occipital scalp. With a uniform flap dissecting embodiment of apparatus 10, only 3 small (2 cm) incisions are made as insertion portals for the device. A continuous uniform flap of the scalp, face and neck is developed. With a process termed ‘closed advancement’, the uniform subcutaneous flap is then advanced upwards (superiorly) on the face and temporal scalp and the flap is advanced backwards (posteriorly) on the neck and occipital scalp.

[0295]Without resection of skin, the flap is secured in an advanced position with subdermal sutures at the incision portals. With this technique, a more youthful appearance of the face and neck can be achieved without the unsightly scars of the atypical facelift incision. Because the advancement is maintained with a series of subdermal fi...

example 3

[0296]Referring now to FIGS. 66 and 67, for a patient with breast ptosis, large mastopexy (breast uplift incisions that are anchor shaped) incisions can be avoided with closed dissection of the breast skin envelope. Leaving the nipple-areolar complex attached to the underlying breast tissue, the entire breast skin envelope is closed dissected with a uniform flap dissecting embodiment of apparatus 10. For more severe cases of breast ptosis, the entire breast skin envelope including the nipple areolar complex is dissected as a uniform breast skin flap. The uniform breast skin envelope is then advanced superiorly to provide an uplifted contour of the breast. A specifically designed supportive bra can be worn by the patient for 24 hours a day for 3 weeks until adherence of the breast skin flap occurs.

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Abstract

An apparatus for dissecting tissue in a substantially uniform plane of dissection includes a housing configured to be advanced under a tissue layer, and control one of a depth of dissection or tissue flap thickness. The housing thermally shields at least a portion of the tissue flap. A roller is coupled to the housing. The roller is configured to smoothly advance housing over tissue. An energy delivery device is coupled to housing. The energy delivery device is configured to be coupled to an energy source. The energy delivery device has a geometry that substantially defines a plane of dissection.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS[0001]This application is a continuation of U.S. Ser. No. 10 / 620,311 filed Jul. 14, 2003, which application claims the benefit of U.S. Ser. No. 60 / 396,038, filed Jul. 14, 2002, U.S. Ser. No. 60 / 416,206, filed Oct. 3, 2002, and U.S. Ser. No. 60418,089 filed Oct. 13, 2002, all of which applications are fully incorporated herein by reference.BACKGROUND OF THE INVENTIONField of the Invention[0002]This invention relates to a method and apparatus for treating tissue. More particularly, the invention relates to a method for treating tissue using the delivery of energy. Still more particularly the invention relates to a method and apparatus for treating tissue using the delivery of energy to perform electro-surgical procedures.[0003]The human skin is composed of two elements: the epidermis and the underlying dermis. The epidermis with the stratum corneum serves as a biological barrier to the environment. In the basilar layer of the epidermis, pigment-f...

Claims

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Application Information

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Patent Type & Authority Applications(United States)
IPC IPC(8): A61B18/18A61B17/32
CPCA61B17/32093
Inventor KNOWLTON, EDWARD W.
Owner INMODE LTD
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